AUTHOR=Liu Mengyao , Cheng Yang , Wang Xinchang , He Zhaochun , Yang Kepeng , Chen Kai , Fan Yongsheng , Wang Weijie 

TITLE=Diagnosing Rickettsia felis infection with Metagenomic Next-Generation Sequencing (mNGS) in a patient with ankylosing spondylitis: a case report and literature review

JOURNAL=Frontiers in Immunology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1643599

DOI=10.3389/fimmu.2025.1643599

ISSN=1664-3224

ABSTRACT=Rickettsia felis, an emerging flea-borne pathogen with global distribution potential, is a neglected cause of undifferentiated febrile illness, although reported human cases remain sparse. The development of molecular diagnostic methods, along with the application of metagenomic next-generation sequencing (mNGS), has improved the diagnostic accuracy of infectious fevers. A case of Rickettsia felis infection was diagnosed by mNGS in a 55-year-old patient with pre-existing ankylosing spondylitis. Five previously reported cases of Rickettsia felis infection were systematically reviewed, with a comprehensive analysis of their epidemiological characteristics, clinical manifestations, and therapeutic regimens. This study highlights the clinical features and diagnostic approaches of the disease through a case report and literature review.